When we arrive with our clients at the planning process, there are conversations that need to be had about how to move forward. For some clients, it may be very clear how to proceed because they have tried to change the same behavior in the past. Other clients may have several options to choose from related to changing their behavior. Lastly, there may be some clients who have a goal in mind but are not sure how best to get there.
In these scenarios, the conversations will not be the same because each scenario is different. There may be some overlap in the discussions, but all three scenarios will be unique. We will begin to explore the first scenario where the client knows the path they want to take to get to their desired goal. They are not interested in exploring other paths and are ready to begin. It doesn’t mean that the client won’t get lost or confused along the way, but they are clear on how to start their journey.
Below is an example from Miller and Rollnick from a client who sounds ready to stop smoking:
“I know what I need to do, because I’ve quit smoking before. What I need to do is to get off by myself, away from anybody else because I’m impossible to live with for about a week. There is this cabin I like to go to up in the mountains, and I could go up there for a week with no cigarettes. There’s no store anywhere near there-this is really out in the woods. If I know there are no cigarettes around, the craving isn’t as bad. I’m going to take along things I’ve been wanting to read, or just spend time out walking. I think that will work. After a week I’m through the worst of it. The last time I got through a whole week it last for 3 years, but I was pretty hard on people that first week and I didn’t do myself any favors either.”
This client is very clear about what they believe will work best for them. They have tried to quit smoking before and have had some success. The next step is for the clinician to summarize the client’s plan to make sure there is understanding and to see if any additional questions need to be asked. The clinician may follow up with a statement like this:
“What you plan to do, then, is to go to that cabin and stay there for a whole week, taking everything you’ll need, but no tobacco.”
In this scenario, when the client is clear on what path to choose and how to get there, the clinician can simply summarize the plan and think about what else needs to be considered. In our next blog, we will continue with this scenario and explore some follow-up questions to ask this client. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing.
For more information about Motivational Interviewing or related services, contact Steve Bradley-Bull, LCMHC, by phone, (919) 812-9203, or by email, steve_bradley-bull@med.unc.edu
UNC CFAR Motivational Interviewing 